Objective. The effect of postdilation in patients with acute coronary syndrome is still controversial. This meta-analysis aims to analyze the clinical and angiographic outcomes of postdilation after percutaneous coronary intervention in patients with acute coronary syndrome. Methods. PubMed, Embase, the Cochrane Library, Web of Science, CNKI, and Wangfang databases were searched from inception to August 30, 2020. Eligible studies from acute coronary syndrome patients treated with postdilation were included. The primary clinical outcome was major adverse cardiovascular events (MACE), the secondary clinical outcomes comprised all-cause death, stent thrombosis, myocardial infarction, and target vessel revascularization, and the angiographic outcomes were no reflow and slow reflow. Results. 11 studies met inclusion criteria. In clinical outcomes, our pooled analysis demonstrated that the postdilation had a tendency of decreasing MACE (OR = 0.67, 95% CI 0.45–1.00;  = 0.05) but significantly increased all-cause death (OR = 1.49, 95% CI 1.05–2.12;  = 0.03). No significant difference existed in stent thrombosis (OR = 0.71, 95% CI 0.40–1.26;  = 0.24), myocardial infarction (OR = 1.40, 95% CI 0.51–3.83;  = 0.51), and target vessel revascularization (OR = 0.61, 95% CI 0.21–1.80;  = 0.37) between postdilation and non-postdilation groups. In angiographic outcomes, there were no significant differences in no reflow (OR = 1.19, 95% CI 0.54–2.65;  = 0.66) and slow reflow (OR = 1.12, 95% CI 0.93–1.35;  = 0.24) between two groups. Conclusions. The postdilation tends to reduce the risk of MACE but significantly increases all-cause death, without significantly affecting stent thrombosis, myocardial infarction, target vessel revascularization, and coronary TIMI flow grade. However, more randomized controlled trials are required for investigating the effect of postdilation for patients with acute coronary syndrome (registered by PROSPERO, CRD42020160748).

中文翻译：

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急性冠状动脉综合征患者经皮冠状动脉介入治疗后扩张的临床和血管造影结果：系统评价和荟萃分析


客观的。后扩张对急性冠脉综合征患者的效果仍存在争议。本荟萃分析旨在分析急性冠状动脉综合征患者经皮冠状动脉介入治疗后扩张的临床和血管造影结果。方法。检索了 PubMed、Embase、Cochrane Library、Web of Science、CNKI 和万方数据库，检索时间范围为自建库至 2020 年 8 月 30 日。纳入了接受后扩张治疗的急性冠脉综合征患者的符合条件的研究。主要临床结局为主要不良心血管事件（MACE），次要临床结局包括全因死亡、支架内血栓形成、心肌梗死和靶血管血运重建，血管造影结果为无复流和缓慢复流。结果。 11 项研究符合纳入标准。在临床结果中，我们的汇总分析表明，后扩张有降低 MACE 的趋势（OR = 0.67，95% CI 0.45–1.00；= 0.05），但显着增加全因死亡（OR = 1.49，95% CI 1.05–2.12） ; = 0.03)。支架内血栓形成（OR = 0.71，95% CI 0.40–1.26；= 0.24）、心肌梗死（OR = 1.40，95% CI 0.51–3.83；= 0.51）和靶血管血运重建（OR = 0.61，扩张后组和非扩张后组之间的 95% CI 0.21–1.80；= 0.37）。在血管造影结果方面，两组之间无复流（OR = 1.19，95% CI 0.54–2.65；= 0.66）和慢复流（OR = 1.12，95% CI 0.93–1.35；= 0.24）没有显着差异。结论。 后扩张往往会降低 MACE 风险，但会显着增加全因死亡，但不会显着影响支架内血栓形成、心肌梗死、靶血管血运重建和冠状动脉 TIMI 血流分级。然而，还需要更多的随机对照试验来研究后扩张对急性冠状动脉综合征患者的影响（PROSPERO注册，CRD42020160748）。